HJNO Mar/Apr 2022
HEALTHCARE JOURNAL OF NEW ORLEANS I MAR / APR 2022 41 The risk of colorectal cancer has also been associated with low socioeconomic status (both at the individual and area level), and residents in rural or non-metropolitan areas experience greater cancer burden for cancers that can be prevented by screening, such as colorectal cancer. To address these disparities, we must improve awareness of colorectal cancer risk factors, knowledge of family history, and healthcare access for both preventive screening methods and high-quality treatment after diagnosis. Prevention and early detection of col- orectal cancer are essential to alleviating the burden of cancer. The majority of Lou- isiana’s 64 parishes are diagnosing 50-75% of colorectal cancer cases at later stages, when it is more difficult to treat and more likely to result in death. A number of barri- ers prevent people from accessing preven- tive screenings. People enrolled in Medic- aid have experienced historical disparities in healthcare access — it is estimated that prior to Medicaid expansion in Louisiana, half of gastrointestinal providers in Louisi- ana did not accept Medicaid. Also, we know that uninsured individuals and Medicaid enrollees still have difficulty obtaining pre- ventive screenings such as colonoscopies. This is due to disparities in the geographic distribution of providers, especially GI spe- cialists, and because there may be few GI specialists in an area willing to accept the Medicaid rate for colonoscopies. These fac- tors, as well as socioeconomic status, very likely affect screening rates for low-income and rural populations. Screening rates for Louisianans who earn less than $15,000 per year were 30% lower than Louisianans who earn $50,000 or more, and this disparity is growing. For these reasons, LDH has prioritized colorectal cancer in its programming during and early detection services via their mobile medical clinic at no out-of-pocket cost. A number of preventive screening tests can be used depending on patient prefer- ence, including a colonoscopy and a num- ber of stool-based tests that can be done at home. A stool-based test can be obtained at a Prevention on the Go screening event or through a medical provider. Cologuard is one of these at-home tests, covered by most insurers, which can be obtained through your medical provider or through a telemedicine provider online by visiting www.cologuard.com . At LDH, we know that our work is most impactful and successful when we do not work in silos. Our actions can result in the communities we serve having access to a screening event, taking an at-home test, or making an appointment for a colonoscopy. Teamwork and coordination can make the difference in community screening, which can in turn save lives. It’s all part of who we are as Louisiana residents and Louisiana health profession- als. We look out for each other. We take care of each other.We become healthier together. If you would like to get involved or access LDH’s Colorectal Cancer Toolkit to learn more about what LDH is doing to increase screening rates, you can contact us at Katye. Magee@la.gov. A full list of Prevention on the Go screening events can be found at marybird.org/get-screened. n KatyeMagee serves as the policy director at the Louisi- ana Department of Health.Prior to LDH,she worked in public health and policy research at the NationalAcad- emies of Sciences,Engineering,andMedicine and the American College of Obstetricians and Gynecologists, covering the topics of women’s health, digital health, healthcare services,veteran health,and global health. Born and raised in south Mississippi, Katye earned a Bachelor of Science in Public Health from Tulane University and aMaster of PublicAdministration from The GeorgeWashington University. fiscal year 2022 and set a goal to increase screening across the state. We believe that through focused, coordinated action across our department, and in alignment with our external partners, we can significantly im- prove screening rates and impact the rates of colorectal cancer morbidity and mortal- ity in our state. In 2018, the National Col- orectal Cancer Roundtable developed a na- tional goal of achieving a colorectal cancer screening rate of 80% among those ages 50- 74 in every community. Our strategy aims to move Louisiana closer to this goal, especial- ly for our communities who have previously struggled the most to access these life-sav- ing services. This strategy includes a colorectal cancer toolkit we’re sharing with our local govern- ing entities, other state agencies, legislators, parish health units, Medicaid managed care organizations (MCOs), federally qualified health centers, and rural health centers. Our 24-hour state facilities are working to identify eligible patients who have not been screened for colorectal cancer and then provide a screening test to as many con- senting patients as possible before June 30, 2022. Our MCOs are conducting outreach to eligible Medicaid members to educate them on colorectal cancer risks and the impor- tance of preventive screenings, help locate a provider or screening events and schedule appointments for screening tests, and co- ordinate transportation, as well as hosting screening events throughout the state. We are urging all providers to commit to this goal and do all they can to support their pa- tients in obtaining a preventive screening. We’ve also partnered with Mary Bird Per- kins Cancer Center on their Prevention on the Go program to host a number of screen- ing events. Through this program, people throughout the state will receive education Katye Magee Policy Director Louisiana Department of Health
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